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Office of Public and Intergovernmental Affairs

Remarks by Secretary Robert A. McDonald

It’s been almost exactly one year since I stood beside HVAC Chairman Jeff Miller at the White House as President Obama signed into law the Clay Hunt Suicide Prevention for American Veterans Act, giving VA additional authority to expand suicide prevention efforts for Veterans in partnership with the community.

The act builds on a long series of executive orders issued by the President to improve access to mental health services for Veterans, Servicemembers, and their families. And so I want to thank Chairman Miller and also Senators John McCain and Richard Blumenthal for their determination in getting this important legislation through Congress.

We’re pleased to have Chairman Miller here with us this morning and look forward to hearing a few words from him shortly. Thank you for joining us, Mr. Chairman.

I also want to thank Clay Hunt's mother and stepfather, Susan and Richard Selke, as well as Jean and Howard Somers, who also lost their son Daniel to suicide. Both of these couples turned their grief into action—to give hope to the hopeless, and to save others from knowing the pain they have known. We’re grateful to them for their courage and perseverance and are honored to have them here today.

There are two other people I’d like to thank for being here. Both are very important partners in serving Veterans:

Senator Elizabeth Dole, who’s here to speak on behalf of the Nation’s “hidden heroes”—the five-and-a-half million full-time caregivers who care for disabled Veterans unable to manage by themselves. Always good to see you, Senator.

And Lee Woodruff of the Bob Woodruff Foundation. Since 2006, the Woodruffs have made it their mission to navigate the maze of 46,000 nonprofits serving Veterans to find and fund the most promising, the most innovative programs helping Veterans. We’re so impressed by their work that last November we signed a formal Memorandum of Understanding with the Woodruff Foundation—to build on our past partnership by working even closer together. Acting as moderator for this event wasn’t mentioned in the memorandum, but Lee graciously agreed to do us the honor, and we’re very grateful to her for doing so. Thank you, Lee.

A couple of weeks ago, Dr. Shulkin and I testified before the Senate Veterans’ Affairs Committee on our effort to make VA the No. 1 customer-service agency in the federal government. It’s called MyVA, and one of its five main objectives is to enhance strategic partnerships.

It’s a little known fact that the VA we know today was founded on partnerships. In the aftermath of World War II, Gen. Omar Bradley, as VA administrator, reached out to medical colleges and universities across the country to enlist them in the cause of caring for the Veterans returning from Europe and the Pacific. The partnerships he formed are still the basis of VA healthcare. Without them, VA could not accomplish its mission of caring for Veterans, their families, and their survivors.

Our MyVA initiative will build on that model to involve many others in collaborative efforts—to do what no single agency or organization can do alone. As the President said in signing the Clay Hunt Act, “This is not just a job for government. Every community, every American, can reach out and do more with and for our Veterans. This has to be a national mission.”

For our part, VA is continuing to expand and improve its Veterans Crisis Line, which has answered nearly 2 million calls since its launch in 2007. Nearly a quarter of those calls were answered in just last fiscal year—490,000. That gives you an idea how much we’ve ramped up our efforts.

The same is true for referrals to local VA Suicide Prevention Coordinators: One quarter of the 320,000 referrals made so far by Crisis-line counsellors were made in FY 2015. Crisis-line counsellors have dispatched emergency responders to callers in crisis over 11,000 times last year—and over 53,000 times since 2007. Since adding chat and text services, they have engaged nearly 300,000 Veterans or concerned family members through chat or text.

These aren’t just numbers. In many cases, the numbers represent lives saved.

Just a few weeks ago, a crisis-line counsellor answered a request for chat from a Veteran whose wife had died in the past year. This was the first Christmas in 27 years she wouldn’t be with him, and he was depressed and needed someone to talk to. It turned out that he had called the Veterans Crisis Line before, and that time he had already decided to end his life before his daughter woke up—but talking to a crisis-line counsellor named Cynthia changed his mind. Remembering that moment made him want to contact the crisis line again to thank Cynthia for bringing him back “from the dark side to the bright side,” he said. This is God’s work we’re doing, on behalf of the American people.

We can be there for troubled Veterans thanks to the support of the President and Congress, who have provided the funding to allow us to expand our suicide prevention and mental health services.

Since 2009, we’ve hired nearly 9,000 more mental health clinicians, boosting their ranks by 65%. We now have over 22,500 clinicians providing mental health services—psychiatrists, psychologists, social workers, mental health counselors, and family therapists. Access to mental health services has improved greatly. The average wait time for mental health appointments is now just three days, compared to 4 days for primary care and 5 days for specialty care.

VA is also a leader in mental health research, including the kind of studies only very large health-care organizations like VA can conduct.

Last year we began a landmark study on the use of lithium to treat patients at risk of suicide. Lithium has been prescribed for decades to treat depression, but there’s never been a large-scale study proving its effectiveness at preventing suicide. VA is uniquely positioned to conduct such a study. With 30 VA facilities participating, the study will be one of the largest medication trials for suicide prevention.

Other studies are looking at the effectiveness of other therapies and medications, as well as whether genetics contributes to depression and suicidality.

In recent years, suicide rates have risen steadily for the general population, but not for Veterans in the VA system. For the Veterans in our care, rates have remained stable—maybe even declined slightly—which tells us that treatment works.

But less than half of the Veterans in this country are in the VA healthcare system, and among those who are, it’s still a challenge identifying who’s at risk of suicide. There are some obvious indicators of risk—like schizophrenia, bipolar disorder, clinical depression, and a history of mental illness. But then there are other indications like PTSD, substance abuse, chronic pain, and sleep disorders.

Younger Veterans are still more likely to attempt suicide than non-Veterans of the same age. That may always be the case. Military service, especially combat service, is extremely trying and often traumatic—physically, mentally, and spiritually.

But it’s estimated that 70% of Veterans committing suicide are over 50. These are men and women struggling with the effects of age—declining health, increasing disability, financial worries, and, maybe most of all, loneliness.

Part of what we’re up against is changing public opinion about suicide. Fewer Americans have been raised to believe suicide is always wrong. More and more believe suicide makes sense, when life brings you more pain than pleasure and there’s no other end in sight. Part of our challenge is to convince Veterans that that’s a wrong way of thinking—for many reasons, including the pain inflicted on the loved ones left behind.

For both older and younger Veterans, there’s another category of people at risk who fall within our area of concern. Our mission statement still comes from President Lincoln’s promise “to care for him who shall have borne the battle, and for his widow and his orphan.” We’ve updated that to “those who have borne the battle and their families and survivors.” Their families include their caregivers, who often bear extraordinary burdens on behalf of invalid Veterans.

Last May, I attended a Caregiver Summit hosted by the Elizabeth Dole Foundation, where I heard a caregiver share her story of having to care for her husband while battling her own depression and despair. She had had thoughts of killing herself, but about that time she met a VA Caregiver Support Coordinator and got involved in VA’s Caregiver Support Program. She said the program saved her life.

I’m grateful to Sen. Dole for being here today to tell us more about the needs of caregivers.

I’m grateful as well to all of our speakers and to everyone in attendance. We depend so much on the work of others to accomplish our mission—on your research, your expertise, your insight, and your commitment to suicide prevention.

At VA, we care for millions of Veterans with sick or broken bodies. We help Veterans live better lives. We sometimes even save lives.

But those of you involved in suicide prevention do even more than that. You don’t just save lives—you save souls. You pull spirits back from the brink of despair, saving them from the worst possible outcome, giving them a second chance at life, and sparing others years of grief. Your work could hardly be more urgent, more honorable, or more deserving of the Nation’s support and encouragement.

No one knows that better than the President. He has demonstrated his support for your efforts time and time again, as he will in the video you’re about to see.